When taken for addressing symptoms of erectile dysfunction , it is capable of projecting a penile erection of about 8 hours, at max. However, it cannot come into action without enough sexual stimulation.
As a phosphodiesterase type 5 inhibitor, Vardenafil has been proven capacity to offer a penial erection of about 8 hours, at max. Vardenafil may also be effective in the treatment of premature ejaculation, where it may significantly delay the occurrence of ejaculation.
This medication might take about 30 minutes from the time of its ingestion, to come into action.
Being an extremely strong medication, it is best not to take more than the prescribed daily dosage intake. On missing a dose, take it as soon as levitra professional for sale you remember. However, if it is nearly time for the next dose, it is better to skip the missed dose and get back to the routine. Once you had this pill it is advised to avoid driving for some time as you may feel sleepy. Keep these tablets away from pets and children.
Contains inactivated NDC Code(s)NDC Code(s): 43353-323-02, 43353-323-06 If you are a consumer or patient please visit this version. DESCRIPTION LEVITRA® is an oral therapy for the treatment of erectile dysfunction. This monohydrochloride salt of vardenafil is a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5).Vardenafil HCl is designated chemically as piperazine, 1-[[3-(1,4-dihydro-5-methyl-4-oxo-7-propylimidazo[5,1-f ][1,2,4]triazin-2-yl)-4-ethoxyphenyl]sulfonyl]-4-ethyl-, monohydrochloride and has the following structural formula:Vardenafil HCl is a nearly colorless, solid substance with a molecular weight of 579.1 g/mol and a solubility of 0.11 mg/mL in water. LEVITRA is formulated as orange, round, film-coated tablets with “BAYER” cross debossed on one side and “2.5”, “5”, “10”, and “20” on the other side corresponding to 2.5 mg, 5 mg, 10 mg, and 20 mg of vardenafil, respectively. LEVITRA® is an oral therapy for the treatment of erectile dysfunction.
Vardenafil HCl is designated chemically as piperazine, 1-[[3-(1,4-dihydro-5-methyl-4-oxo-7-propylimidazo[5,1-f ][1,2,4]triazin-2-yl)-4-ethoxyphenyl]sulfonyl]-4-ethyl-, monohydrochloride and has the following structural formula: Vardenafil HCl is a nearly colorless, solid substance with a molecular weight of 579.1 g/mol and a solubility of 0.11 mg/mL in water. CLINICAL PHARMACOLOGY Mechanism of ActionPenile erection is a hemodynamic process initiated by the relaxation of smooth muscle in the corpus cavernosum and its associated arterioles. During sexual stimulation, nitric oxide is released from nerve endings and endothelial cells in the corpus cavernosum. Nitric oxide activates the enzyme guanylate cyclase resulting in increased synthesis of cyclic guanosine monophosphate (cGMP) in the smooth muscle cells of the corpus cavernosum. The cGMP in turn triggers smooth muscle relaxation, allowing increased blood flow into the penis, resulting in erection. It offers a penile erection of about 8 hours, at the max. A Vardenafil 60 mg tablet should be gulped down as a whole tablet, with the help of plain water. The tablet should never be broken in halves and taken in intervals, or be dissolved in water, or crushed. This medication should be taken only with plain water and not with alcohol, coffee, tea, grape juice, etc. It can be taken both with food and without food. It is better to maintain a fixed time for this medication. Foods, supplements, or medicines containing nitric components Alcohol or beverages like tea, coffee, etc. Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs It should be noted here that Vardenafil is an FDA-approved safe medication, that has already been used by numerous patients across the world, and these probable severe side effects may happen in very rare cases.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Levitra Generic | 20mg | 120 + 10 Pills | 224.15€ 213.48€ | |
| Levitra Generic | 60mg | 20 Pills | 81.30€ 77.43€ | |
| Levitra Original | 20mg | 92 + 4 Pills | 406.22€ 386.88€ | |
| Levitra Generic | 60mg | 10 Pills | 47.42€ 45.16€ | |
| Levitra Generic | 40mg | 10 Pills | 41.37€ 39.40€ | |
| Levitra Generic | 20mg | 90 + 8 Pills | 180.78€ 172.17€ | |
| Levitra Soft Tabs | 20mg | 30 + 2 Pills | 99.17€ 94.45€ | |
| Levitra Generic | 60mg | 60 + 4 Pills | 198.85€ 189.38€ | |
| Levitra Generic | 10mg | 30 + 4 Pills | 62.39€ 59.42€ | |
| Levitra Soft Tabs | 20mg | 60 + 4 Pills | 178.40€ 169.90€ | |
| Levitra Professional | 20mg | 180 + 4 Pills | 502.31€ 478.39€ | |
| Levitra Generic | 40mg | 270 + 10 Pills | 561.89€ 535.13€ | |
| Levitra Generic | 40mg | 60 + 4 Pills | 162.37€ 154.64€ | |
| Levitra Professional | 20mg | 270 + 6 Pills | 738.98€ 703.79€ |
Hence, it is better to have constant guidance from a doctor. Certain pulmonary hypertension drugs, such as riociguat (Adempas) Protease inhibitors, a class of HIV medications Antifungal drugs, such as ketoconazole and itraconazole (Onmel, Sporanox) Do not miss the dosage prescribed by the doctor. Being an extremely strong medication, it is best not to take more than the prescribed daily dosage intake. On missing a dose, take it as soon as levitra professional for sale you remember. However, if it is nearly time for the next dose, it is better to skip the missed dose and get back to the routine. Once you had this pill it is advised to avoid driving for some time as you may feel sleepy. Keep these tablets away from pets and children.
When taken for addressing symptoms of erectile dysfunction , it is capable of projecting a penile erection of about 8 hours, at max. However, it cannot come into action without enough sexual stimulation. As a phosphodiesterase type 5 inhibitor, Vardenafil has been proven capacity to offer a penial erection of about 8 hours, at max. Vardenafil may also be effective in the treatment of premature ejaculation, where it may significantly delay the occurrence of ejaculation. This medication might take about 30 minutes from the time of its ingestion, to come into action.
It offers a penile erection of about 8 hours, at the max. A Vardenafil 60 mg tablet should be gulped down as a whole tablet, with the help of plain water. The tablet should never be broken in halves and taken in intervals, or be dissolved in water, or crushed. This medication should be taken only with plain water and not with alcohol, coffee, tea, grape juice, etc. It can be taken both with food and without food.
It is better to maintain a fixed time for this medication. Foods, supplements, or medicines containing nitric components Alcohol or beverages like tea, coffee, etc. Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs It should be noted here that Vardenafil is an FDA-approved safe medication, that has already been used by numerous patients across the world, and these probable severe side effects may happen in very rare cases. Hence, it is better to have constant guidance from a doctor. Certain pulmonary hypertension drugs, such as riociguat (Adempas) Protease inhibitors, a class of HIV medications Antifungal drugs, such as ketoconazole and itraconazole (Onmel, Sporanox) Do not miss the dosage prescribed by the doctor. Contains inactivated NDC Code(s)NDC Code(s): 43353-323-02, 43353-323-06 If you are a consumer or patient please visit this version. DESCRIPTION LEVITRA® is an oral therapy for the treatment of erectile dysfunction.
This monohydrochloride salt of vardenafil is a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5).Vardenafil HCl is designated chemically as piperazine, 1-[[3-(1,4-dihydro-5-methyl-4-oxo-7-propylimidazo[5,1-f ][1,2,4]triazin-2-yl)-4-ethoxyphenyl]sulfonyl]-4-ethyl-, monohydrochloride and has the following structural formula:Vardenafil HCl is a nearly colorless, solid substance with a molecular weight of 579.1 g/mol and a solubility of 0.11 mg/mL in water. LEVITRA is formulated as orange, round, film-coated tablets with “BAYER” cross debossed on one side and “2.5”, “5”, “10”, and “20” on the other side corresponding to 2.5 mg, 5 mg, 10 mg, and 20 mg of vardenafil, respectively. LEVITRA® is an oral therapy for the treatment of erectile dysfunction. Vardenafil HCl is designated chemically as piperazine, 1-[[3-(1,4-dihydro-5-methyl-4-oxo-7-propylimidazo[5,1-f ][1,2,4]triazin-2-yl)-4-ethoxyphenyl]sulfonyl]-4-ethyl-, monohydrochloride and has the following structural formula: Vardenafil HCl is a nearly colorless, solid substance with a molecular weight of 579.1 g/mol and a solubility of 0.11 mg/mL in water. CLINICAL PHARMACOLOGY Mechanism of ActionPenile erection is a hemodynamic process initiated by the relaxation of smooth muscle in the corpus cavernosum and its associated arterioles.
| Brand Name | Manufacturer | Price per Tablet | Packaging Options | Generic Available |
|---|---|---|---|---|
| Levitra | Bayer | $10.00 | 10, 20, 30 tablets | Yes |
| Vardenafil-Sandoz | Sandoz | $9.50 | 10 tablets | Yes |
| Staxyn | Bayer | $12.00 | 10 tablets | No |
During sexual stimulation, nitric oxide is released from nerve endings and endothelial cells in the corpus cavernosum. Nitric oxide activates the enzyme guanylate cyclase resulting in increased synthesis of cyclic guanosine monophosphate (cGMP) in the smooth muscle cells of the corpus cavernosum.
The cGMP in turn triggers smooth muscle relaxation, allowing increased blood flow into the penis, resulting in erection. The tissue concentration of cGMP is regulated by both the rates of synthesis and degradation via phosphodiesterases (PDEs). The most abundant PDE in the human corpus cavernosum is the cGMP-specific phosphodiesterase type 5 (PDE5); therefore, the inhibition of PDE5 enhances erectile function by increasing the amount of cGMP. Because sexual stimulation is required to initiate the local release generic levitra 20 of nitric oxide, the inhibition of PDE5 has no effect in the absence of sexual stimulation.In vitro studies have shown that vardenafil is a selective inhibitor of PDE5. The inhibitory effect of vardenafil is more selective on PDE5 than for other known phosphodiesterases (>15-fold relative to PDE6, >130-fold relative to PDE1, >300-fold relative to PDE11, and >1,000-fold relative to PDE2, 3, 4, 7, 8, 9, and 10).PharmacokineticsThe pharmacokinetics of vardenafil are approximately dose proportional over the recommended dose range. Vardenafil is eliminated predominantly by hepatic metabolism, mainly by CYP3A4 and to a minor extent, CYP2C isoforms.
The tissue concentration of cGMP is regulated by both the rates of synthesis and degradation via phosphodiesterases (PDEs). The most abundant PDE in the human corpus cavernosum is the cGMP-specific phosphodiesterase type 5 (PDE5); therefore, the inhibition of PDE5 enhances erectile function by increasing the amount of cGMP. Because sexual stimulation is required to initiate the local release generic levitra 20 of nitric oxide, the inhibition of PDE5 has no effect in the absence of sexual stimulation.In vitro studies have shown that vardenafil is a selective inhibitor of PDE5. The inhibitory effect of vardenafil is more selective on PDE5 than for other known phosphodiesterases (>15-fold relative to PDE6, >130-fold relative to PDE1, >300-fold relative to PDE11, and >1,000-fold relative to PDE2, 3, 4, 7, 8, 9, and 10).PharmacokineticsThe pharmacokinetics of vardenafil are approximately dose proportional over the recommended dose range. Vardenafil is eliminated predominantly by hepatic metabolism, mainly by CYP3A4 and to a minor extent, CYP2C isoforms.
Concomitant use with potent CYP3A4 inhibitors such as ritonavir, indinavir, ketoconazole, as well as moderate CYP3A inhibitors such as erythromycin results in significant increases of plasma levels of vardenafil (see PRECAUTIONS, WARNINGS and DOSAGE AND ADMINISTRATION). Mean vardenafil plasma concentrations measured after the administration of a single oral dose of 20 mg to healthy male volunteers are depicted in Figure 1.Figure 1: Plasma Vardenafil Concentration (Mean ± SD) Curve for a Single 20 mg LEVITRA DoseAbsorption:Vardenafil is rapidly absorbed with absolute bioavailability of approximately 15%. Maximum observed plasma concentrations after a single 20 mg dose in healthy volunteers are usually reached between 30 minutes and 2 hours (median 60 minutes) after oral dosing in the fasted state. Two food-effect studies were conducted which showed that high-fat meals caused a reduction in Cmax by 18%-50%.Distribution:The mean steady-state volume of distribution (Vss) for vardenafil is 208 L, indicating extensive tissue distribution. Vardenafil and its major circulating metabolite, M1, are highly bound to plasma proteins (about 95% for parent drug and M1).
This protein binding is reversible and independent of total drug concentrations.Following a single oral dose of 20 mg vardenafil in healthy volunteers, a mean of 0.00018% of the administered dose was obtained in semen 1.5 hours after dosing.Metabolism:Vardenafil is metabolized predominantly by the hepatic enzyme CYP3A4, with contribution from the CYP3A5 and CYP2C isoforms. The major circulating metabolite, M1, results from desethylation at the piperazine moiety of vardenafil. The plasma concentration of M1 is approximately 26% that of the parent compound. This metabolite shows a phosphodiesterase selectivity profile similar to that of vardenafil and an in vitro inhibitory potency for PDE5 28% of that of vardenafil. Therefore, M1 accounts for approximately 7% of total pharmacologic activity.Excretion:The total body clearance of vardenafil is 56 L/h, and the terminal half-life of vardenafil and its primary metabolite (M1) is approximately 4-5 hours. Concomitant use with potent CYP3A4 inhibitors such as ritonavir, indinavir, ketoconazole, as well as moderate CYP3A inhibitors such as erythromycin results in significant increases of plasma levels of vardenafil (see PRECAUTIONS, WARNINGS and DOSAGE AND ADMINISTRATION). Mean vardenafil plasma concentrations measured after the administration of a single oral dose of 20 mg to healthy male volunteers are depicted in Figure 1.Figure 1: Plasma Vardenafil Concentration (Mean ± SD) Curve for a Single 20 mg LEVITRA DoseAbsorption:Vardenafil is rapidly absorbed with absolute bioavailability of approximately 15%.
After oral administration, vardenafil is excreted as metabolites predominantly in the feces (approximately 91-95% of administered oral dose) and to a lesser extent in the urine (approximately 2-6% of administered oral dose).Pharmacokinetics in Special PopulationsPediatrics: Vardenafil trials were not conducted in the pediatric population.Geriatrics: In a healthy volunteer study of elderly males (≥65 years) and younger males (18–45 years), mean Cmax and AUC were 34% and 52% higher, respectively, in the elderly males (see PRECAUTIONS, Geriatric Use and DOSAGE AND ADMINISTRATION). Consequently, a lower starting dose of LEVITRA (5 mg) in patients ≥65 years of age should be considered.Renal Insufficiency: In volunteers with mild renal impairment (CLcr = 50-80 ml/min), the pharmacokinetics of vardenafil were similar to those observed in a control group with normal renal function. In the moderate (CLcr = 30-50 ml/min) or severe (CLcr<30 ml/min) renal impairment groups, the AUC of vardenafil was 20–30% higher compared to that observed in a control group with normal renal function (CLcr>80 ml/min). Vardenafil pharmacokinetics have not been evaluated in patients requiring renal dialysis (see PRECAUTIONS, Renal Insufficiency, and DOSAGE AND ADMINISTRATION).Hepatic Insufficiency: In volunteers with mild hepatic impairment (Child-Pugh A), the Cmax and AUC following a 10 mg vardenafil dose were increased by 22% and 17%, respectively, compared to healthy control subjects. In volunteers with moderate hepatic impairment (Child-Pugh B), the Cmax and AUC following a 10 mg vardenafil dose were increased by 130% and 160%, respectively, compared to healthy control subjects.
Consequently, a starting dose of 5 mg is recommended for patients with moderate hepatic impairment, and the maximum dose should not exceed 10 mg (see PRECAUTIONS and DOSAGE AND ADMINISTRATION). Vardenafil has not been evaluated in patients with severe (Child-Pugh C) hepatic impairment.PharmacodynamicsEffects on Blood Pressure:In a clinical pharmacology study of patients with erectile dysfunction, single doses of vardenafil 20 mg caused a mean maximum decrease in supine blood pressure of 7 mmHg systolic and 8 mmHg diastolic (compared to placebo), accompanied by a mean maximum increase of heart rate of 4 beats per minute. The maximum decrease in blood pressure occurred between 1 and 4 hours after dosing. Following multiple dosing for 31 days, similar blood pressure responses were observed on Day 31 as on Day 1. Vardenafil may add to the blood pressure lowering effects of antihypertensive agents (see PRECAUTIONS, Drug Interactions).Effects on Blood Pressure and Heart Rate when LEVITRA is Combined with Nitrates:A study was conducted in which the blood pressure and heart rate response to 0.4 mg nitroglycerin (NTG) sublingually was evaluated in 18 healthy subjects following pretreatment with LEVITRA 20 mg at various times before NTG administration. Maximum observed plasma concentrations after a single 20 mg dose in healthy volunteers are usually reached between 30 minutes and 2 hours (median 60 minutes) after oral dosing in the fasted state. Two food-effect studies were conducted which showed that high-fat meals caused a reduction in Cmax by 18%-50%.Distribution:The mean steady-state volume of distribution (Vss) for vardenafil is 208 L, indicating extensive tissue distribution. Vardenafil and its major circulating metabolite, M1, are highly bound to plasma proteins (about 95% for parent drug and M1). This protein binding is reversible and independent of total drug concentrations.Following a single oral dose of 20 mg vardenafil in healthy volunteers, a mean of 0.00018% of the administered dose was obtained in semen 1.5 hours after dosing.Metabolism:Vardenafil is metabolized predominantly by the hepatic enzyme CYP3A4, with contribution from the CYP3A5 and CYP2C isoforms.
| Country | Prescription Required | Legal Purchase | Age Restriction | Notes |
|---|---|---|---|---|
| United States | Yes | Yes | 18+ | Sold with prescription |
| United Kingdom | Yes | Yes | 18+ | Regulated by MHRA |
| Canada | Yes | Yes | 18+ | Sold via licensed pharmacies |
| Australia | Yes | Yes | 18+ | Strict regulations |
The major circulating metabolite, M1, results from desethylation at the piperazine moiety of vardenafil.
| Dosage | Timing Before Activity | Maximum Daily Dose | Food Interactions |
|---|---|---|---|
| 60 mg (standard) | 30-60 minutes before sex | 1 tablet | Avoid fatty meals |
| 20-40 mg (alternative) | 30 minutes prior | 1 tablet | Alcohol may reduce effectiveness |
| 80 mg (max dose) | Under Doctor supervision | 1 tablet | Consult doctor first |
The plasma concentration of M1 is approximately 26% that of the parent compound. This metabolite shows a phosphodiesterase selectivity profile similar to that of vardenafil and an in vitro inhibitory potency for PDE5 28% of that of vardenafil. Therefore, M1 accounts for approximately 7% of total pharmacologic activity.Excretion:The total body clearance of vardenafil is 56 L/h, and the terminal half-life of vardenafil and its primary metabolite (M1) is approximately 4-5 hours. After oral administration, vardenafil is excreted as metabolites predominantly in the feces (approximately 91-95% of administered oral dose) and to a lesser extent in the urine (approximately 2-6% of administered oral dose).Pharmacokinetics in Special PopulationsPediatrics: Vardenafil trials were not conducted in the pediatric population.Geriatrics: In a healthy volunteer study of elderly males (≥65 years) and younger males (18–45 years), mean Cmax and AUC were 34% and 52% higher, respectively, in the elderly males (see PRECAUTIONS, Geriatric Use and DOSAGE AND ADMINISTRATION). Consequently, a lower starting dose of LEVITRA (5 mg) in patients ≥65 years of age should be considered.Renal Insufficiency: In volunteers with mild renal impairment (CLcr = 50-80 ml/min), the pharmacokinetics of vardenafil were similar to those observed in a control group with normal renal function. In the moderate (CLcr = 30-50 ml/min) or severe (CLcr<30 ml/min) renal impairment groups, the AUC of vardenafil was 20–30% higher compared to that observed in a control group with normal renal function (CLcr>80 ml/min). Vardenafil pharmacokinetics have not been evaluated in patients requiring renal dialysis (see PRECAUTIONS, Renal Insufficiency, and DOSAGE AND ADMINISTRATION).Hepatic Insufficiency: In volunteers with mild hepatic impairment (Child-Pugh A), the Cmax and AUC following a 10 mg vardenafil dose were increased by 22% and 17%, respectively, compared to healthy control subjects. In volunteers with moderate hepatic impairment (Child-Pugh B), the Cmax and AUC following a 10 mg vardenafil dose were increased by 130% and 160%, respectively, compared to healthy control subjects. Consequently, a starting dose of 5 mg is recommended for patients with moderate hepatic impairment, and the maximum dose should not exceed 10 mg (see PRECAUTIONS and DOSAGE AND ADMINISTRATION). Vardenafil has not been evaluated in patients with severe (Child-Pugh C) hepatic impairment.PharmacodynamicsEffects on Blood Pressure:In a clinical pharmacology study of patients with erectile dysfunction, single doses of vardenafil 20 mg caused a mean maximum decrease in supine blood pressure of 7 mmHg systolic and 8 mmHg diastolic (compared to placebo), accompanied by a mean maximum increase of heart rate of 4 beats per minute. The maximum decrease in blood pressure occurred between 1 and 4 hours after dosing. Following multiple dosing for 31 days, similar blood pressure responses were observed on Day 31 as on Day 1. Vardenafil may add to the blood pressure lowering effects of antihypertensive agents (see PRECAUTIONS, Drug Interactions).Effects on Blood Pressure and Heart Rate when LEVITRA is Combined with Nitrates:A study was conducted in which the blood pressure and heart rate response to 0.4 mg nitroglycerin (NTG) sublingually was evaluated in 18 healthy subjects following pretreatment with LEVITRA 20 mg at various times before NTG administration.